Grindr, Scruff, and on the Hunt: Predictors of Condomless Anal Sex, Internet Use, and Mobile Application Use Among Men Who Have Sex With Men

Dating App Use and Sexual Risk: Understanding the Associations between Casual Sex Motivation, Number of Sexual Partners, and STI Diagnoses

Objective: This study focused on casual sex motivation to explore why some users tend to have more sexual partners and are more likely to take risks in sexual practices, thereby raising their chances of contracting sexually transmitted infections (STIs). Methods: We recruited Chinese heterosexual dating app users (N = 582) online to investigate the serial mediation model. Results: Casual sex motivation for dating app use was not directly related to the diagnoses of STIs. Number of sexual partners and frequency of risky sexual behavior serially mediated the relationship between casual sex motivation and STI diagnoses. Conclusions: Using dating apps for casual sex motivation is not necessarily associated with higher incidences of STIs, provided that users do not engage in risky sexual practices.

Online partner seeking and high-risk behaviour in men who have sex with men and male-to-female transgendered people in Mumbai, India: Implications for prevention strategies

BACKGROUND

It is important to understand the current internet-related sexual behaviours of high-risk groups such as men who have sex with men (MSM). We designed the present study to understand the types of online/mobile apps used by MSM and male-to-female transgendered people/hijras [TGH] in Mumbai, India. We also compared the internet-related 'partner seeking' and 'sexual behaviours' in MSM and TGH in Mumbai, India.

METHODS

This is a cross-sectional analysis of secondary data collected (April to June 2020) from 8582 MSM and 4163 TGH from five targeted intervention programmes each in Mumbai, Maharashtra, India. Data on demographics, years of association with the intervention, number and type of online/mobile apps used, sexual behaviours including partners from virtual space and non-virtual (physical) space, group sex, attending parties, mobility for sexual partners, and HIV status were collected.

RESULTS

MSM were more likely to have mobile phone (88% vs 51%, p < 0.001) and internet access over the phone (78% vs 27%; p < 0.001) compared with TGH. The common apps used by MSM were Grindr (48%), Facebook (42%), and Blued (36%). MSM were more likely to have partners from virtual space (91% vs 67%; p < 0.001). A higher proportion of MSM had attended parties (28% vs 2%; p < 0.001), had group sex (16% vs 6%; p < 0.001), and were mobile for sex (25% vs 4%). MSM and TGH who had partners from virtual space were significantly more likely to report 'missed a condom at least once during penetrative sex in the past one week' (17% vs 12%; p<0.001). In HIV positive MSM, group sex, parties, and mobility for sex, were only in those who reported partners from the virtual space.

CONCLUSIONS

Internet-based interventions for MSM should be incorporated in the existing targeted intervention programme and outreach workers should be trained in virtual outreach services. Among TGH, given the low reach and use of smartphones and apps, internet-based interventions may not be such a useful option, and the existing physical targeted intervention programmes should be strengthened.

A Qualitative Assessment among Personnel Working in Community-Led Development Program Settings Regarding Sexualized Substance Use

Sexualized substance use (SSU) is the practice of psychotropic substance use before or during sex to increase sexual pleasure. The growing use of SSU has a strong association with sexually transmitted infections (STIs). Community health mobilizers (CHMs) are agents who assist in decreasing the global burden of disease in the communities they serve. They work as unit managers, counselors, or field workers. The managers and counselors have a minimum of a bachelor’s degree, and field workers have a minimum of a higher secondary education. This study aimed to qualitatively assess the knowledge gaps regarding SSU among CHMs. In-depth interviews (IDIs) were conducted in New Delhi, India with nineteen CHMs. Majority of the CHMs were men (n = 9, 47%) followed by transgender (TG) persons (TG females n = 5, 26.3%; TG males n = 1, 5.2%), and women (n = 4, 21.1%). Knowledge gaps were identified among the CHMs regarding different types of sexualized substances, drug procurement, human immunodeficiency virus (HIV) infection prevention, and complex health issues associated with SSU. It suggested the need for periodic workshops and training for upgradation of existing knowledge and practices among the CHMs. This formative research may help social scientists to develop protocols for conducting multi-centric, community-based studies across the country for further validation and exploration.

Behind the Screens: A Systematic Literature Review of Quantitative Research on Mobile Dating

Mobile dating applications (MDAs) have become commonly used tools to seek out dating and sexual partners online. The current review aimed to systematically synthesize empirical findings in 72 quantitative studies on mobile dating, published in ISI-ranked journals between 2014 and 2020. This review focused on summarizing different approaches toward mobile dating, identity features of quantitative research on mobile dating, and hypothesized antecedents and outcomes of mobile dating. Our findings showed, first, that the literature diverges in how mobile dating is operationalized. Second, quantitative research on mobile dating predominantly consists of cross-sectional studies that draw on theoretical insights from multiple disciplines. Third, a variety of traits and sociodemographics were associated with MDA use. In particular, using MDAs for (1) relational goals related to being male, non-heterosexual, higher levels of sociosexuality, sensation seeking, extraversion, and holding more positive peer norms about using MDAs for relational goals; (2) intrapersonal goals related to being female and having more socially impairing traits; and (3) entertainment goals related to having higher levels of sociosexuality, sensation seeking, and antisocial traits. Outcomes significantly associated with general use of MDAs were scoring higher on sexual permissiveness and on engaging in casual (unprotected) sexual intercourse, as well as having higher risk at nonconsensual sex. MDA use was also connected with increased psychological distress and body dissatisfaction. Shortcomings of the existing research approaches and measures are discussed and six methodological and theoretical recommendations for future research are provided.

Gay Dating App Users Support and Utilize Sexual Health Features on Apps

Men who have sex with men (MSM) frequently meet sex partners through dating apps. Research has demonstrated an association between app use and greater number of sex partners and STIs, but dating apps also pose an opportunity for intervention. By advocating for sexual health features on dating apps, Building Healthy Online Communities (BHOC) aims to increase communication about sexual health among app users. In partnership with Emory University, BHOC added questions to an annual survey of MSM. The questions assessed awareness and uptake of profile fields and sexual health features on the dating apps. Among survey participants, 67% (6737/10,129) reported using dating apps to meet a partner in the past year. Among this group, 77% (4993/6525) reported awareness of sexual health features. 61% of app users (2866/4721) who were aware of them reported using one or more sexual health features. BHOC continues to advocate for increased uptake of these features.

Casual Sex among Men Who Have Sex with Men (MSM) during the Period of Sheltering in Place to Prevent the Spread of COVID-19

OBJECTIVES

We investigated the extent to which Brazilian and Portuguese Men Who Have Sex with Men (MSM) had casual sex partners outside their homes during the period of sheltering in place for the COVID-19 pandemic.

METHODS

An online survey was conducted in Brazil and Portugal in April, during the period of social isolation for COVID-19, with a sample of 2361 MSMs. Recruitment was done through meeting apps and Facebook.

RESULTS

Most of the sample (53.0%) had casual sex partners during sheltering. Factors that increased the odds of engaging in casual sex in Brazil were having group sex (aOR 2.1, 95% CI 1.3-3.4), living in an urban area (aOR 1.6, 95% CI 1.1-2.2), feeling that sheltering had a high impact on daily life (aOR 3.0, 95% CI 1.1-8.3), having casual instead of steady partners (aOR 2.5, 95% CI 1.8-3.5), and not decreasing the number of partners (aOR 6.5, 95% CI 4.2-10.0). In Portugal, the odds of engaging in casual sex increased with using Facebook to find partners (aOR 4.6, 95% CI 3.0-7.2), not decreasing the number of partners (aOR 3.8, 95% CI 2.9-5.9), usually finding partners in physical venues (pre-COVID-19) (aOR 5.4, 95% CI 3.2-8.9), feeling that the isolation had a high impact on daily life (aOR 3.0, 95% CI 1.3-6.7), and HIV-positive serostatus (aOR 11.7, 95% CI 4.7-29.2). Taking PrEP/Truvada to prevent COVID-19 was reported by 12.7% of MSM.

CONCLUSIONS

The pandemic has not stopped most of our MSM sample from finding sexual partners, with high-risk sexual behaviors continuing.

Casual Sex among Men Who Have Sex with Men (MSM) during the Period of Sheltering in Place to Prevent the Spread of COVID-19

OBJECTIVES

We investigated the extent to which Brazilian and Portuguese Men Who Have Sex with Men (MSM) had casual sex partners outside their homes during the period of sheltering in place for the COVID-19 pandemic.

METHODS

An online survey was conducted in Brazil and Portugal in April, during the period of social isolation for COVID-19, with a sample of 2361 MSMs. Recruitment was done through meeting apps and Facebook.

RESULTS

Most of the sample (53.0%) had casual sex partners during sheltering. Factors that increased the odds of engaging in casual sex in Brazil were having group sex (aOR 2.1, 95% CI 1.3-3.4), living in an urban area (aOR 1.6, 95% CI 1.1-2.2), feeling that sheltering had a high impact on daily life (aOR 3.0, 95% CI 1.1-8.3), having casual instead of steady partners (aOR 2.5, 95% CI 1.8-3.5), and not decreasing the number of partners (aOR 6.5, 95% CI 4.2-10.0). In Portugal, the odds of engaging in casual sex increased with using Facebook to find partners (aOR 4.6, 95% CI 3.0-7.2), not decreasing the number of partners (aOR 3.8, 95% CI 2.9-5.9), usually finding partners in physical venues (pre-COVID-19) (aOR 5.4, 95% CI 3.2-8.9), feeling that the isolation had a high impact on daily life (aOR 3.0, 95% CI 1.3-6.7), and HIV-positive serostatus (aOR 11.7, 95% CI 4.7-29.2). Taking PrEP/Truvada to prevent COVID-19 was reported by 12.7% of MSM.

CONCLUSIONS

The pandemic has not stopped most of our MSM sample from finding sexual partners, with high-risk sexual behaviors continuing.

Strengthening measurement and performance of HIV prevention programmes

Indicators for the measurement of programmes for the primary prevention of HIV are less aligned than indicators for HIV treatment, which results in a high burden of data collection, often without a clear vision for its use. As new evidence becomes available, the opportunity arises to critically evaluate the way countries and global bodies monitor HIV prevention programmes by incorporating emerging data on the strength of the evidence linking various factors with HIV acquisition, and by working to streamline indicators across stakeholders to reduce burdens on health-care systems. Programmes are also using new approaches, such as targeting specific sexual networks that might require non-traditional approaches to measurement. Technological advances can support these new directions and provide opportunities to use real-time analytics and new data sources to more effectively understand and adapt HIV prevention programmes to reflect population movement, risks, and an evolving epidemic.

Complications Related to Sexualized Drug Use: What Can We Learn From Literature?

Chemsex is described as the use of specific psychoactive substances (PS) during sexual activity to sustain, enhance, disinhibit or facilitate the sexual experience. It preferentially concerns men who have sex with men (MSM). They use new synthetic substances like cathinones, methamphetamines, gamma-butyrolactone/gamma-hydroxybutyrate (GBL/GHB), ketamine, and cocaine. The prevalence of chemsex varies from 3 to 31% during lifetime. The Internet has participated significantly in the evolution of sexual behaviors, both in terms of sexual dating and the availability of new synthetic substances. The advent of geolocation applications contributed to the development of chemsex. The literature describes many complications linked to these sexual practices; the main clinical effects related to cathinones consumption were psychiatric symptoms; agitation, hallucinations, anxiety, suicidal ideation, paranoia, and confusion. Regular GBL/GHB consumption alter cognitive functions, particularly memory and emotion management. Use of these drugs in party and play is dramatically associated with high-risk sexual behaviors. The prevalence of hepatitis B, hepatitis C syphilis, and HIV is higher in men who use methamphetamine and Viagra and/or who declared they practiced slamming, chemsex, and fisting. Other sexually transmitted infections (STIs) such as gonorrhea have increased with methamphetamine and GHB/GBL use. Actually, the care of individuals who practice Chemsex in a problematic way is currently not codified, but the use of integrative and specific interventions is necessary.

Online Dating and Problematic Use: A Systematic Review

Despite the constant growth in the use of online dating sites and mobile dating applications, research examining potential problematic use of online dating has remained scarce. Previous research has obviated problematic use of online dating in favour of users’ personality correlates and scams through online dating services. A systematic review was carried out using PsycINFO and Web of Science databases to gather previous findings that address potential problematic use of online dating by (i) identifying use and motivations, (ii) assessing users’ personality correlates, (iii) outlining negative correlates of use, (iv) examining sexual and impulsive behaviour, (v) exploring substance use and behavioural addictions in relation to online dating, and (vi) examining problematic use of online dating, resulting in 43 studies. Findings suggest that personality correlates such as neuroticism, sociability, sensation-seeking, and sexual permissiveness are related to greater use of online dating services. Sex-search and self-esteem enhancement are predictors of problematic use of online dating. Previous research coincides with online dating risks (e.g. fear of deception) and objectification tendency due to online dating services (sites and apps) design. Observations regarding methodological weaknesses and future research implications are included.

Online sex partner seeking and HIV testing frequency among young Black sexual minority men

Dating apps are a novel means of delivering HIV prevention messages. Young black sexual minority men (YBSMM) app users are at high risk for HIV and could benefit from frequent testing. Understanding testing behaviors among YBSMM is critical to inform tailored prevention interventions. We analyzed testing behaviors of 273 YBSMM, comparing typical testing frequency between app users and non-users using odds ratios. Overall, testing rates were high. App users were more likely than non-users to test at least every 12 months. App-using YBSMM exhibit high compliance with testing guidelines, which may indicate future successful uptake of biomedical preventions, such as Pre-Exposure Prophylaxis.

Vulnerability to HIV among older men who have sex with men users of dating apps in Brazil

Introduction

The elderly population is increasingly benefiting from recent technological advances. In this scenario, geolocation-based dating applications provide a viable alternative for finding partners in a practical and timely manner, but may be accompanied by certain risk behaviors for HIV infection. Although there are considerable number of users over 50 on these applications, no studies have addressed this problem. The aim of the present study was to analyze factors of vulnerability to HIV/Aids among the population of men who have sex with men (MSM) age 50 years or older who use dating apps.

Methods

This was a cross-sectional, population-survey-based, analytical study, conducted exclusively online with a sample of 412 MSM. The data was collected from the following apps: Grindr®, Hornet®, Scruff® and Daddy Hunter®.

Results

Factors associated with a higher chance of having HIV were: sexual relations with an HIV-infected partner (ORa = 5.53; 95%CI = 2.23–13.73); chemsex (ORa = 3.97; 95%CI = 1.72–8.92); and, above all, having an HIV-infected partner (ORa = 8.02; 95%CI = 2.01–32.01). The belief that apps increase protection against sexually transmitted infections (ORa = 0.43; 95%CI = 0.19–0.95) and not being familiar with post-exposure prophylaxis (ORa = 0.43; 95%CI = 0.19–0.95) were associated with decreased chances of having HIV.

Conclusions

We highlight some important factors that structure the vulnerability of the MSM surveyed in relation to HIV infection. The findings should be used to customize care for this population, which could bring them in more for health care services.

Viral suppression and HIV transmission behaviors among hospitalized patients living with HIV

From July 2012 to January 2014, the CTN0049 study, Project HOPE (Hospital Visit as Opportunity for Prevention and Engagement for HIV-infected Drug Users) interviewed 1227 people with HIV infection from 11 hospitals in the US to determine eligibility for participation in a randomized trial. Using these screening interviews, we conducted a cross-sectional study with multivariable analysis to examine groups that are at highest risk for having a detectable viral load (VL) and engaging in HIV transmission behaviors. Viral suppression was 42.8%. Persons with a detectable VL were more likely to have sex partners who were HIV-negative or of unknown status (OR = 1.72, 95% CI = 1.22–2.38), report not cleaning needles after injecting drugs (OR = 3.13, 95% CI = 1.33–7.14), and to engage in sex acts while high on drugs or alcohol (OR = 1.85, 95% CI = 1.28–2.7) compared to their counterparts. Many hospitalized people with HIV infection are unsuppressed and more likely to engage in HIV transmission behaviors than those with viral suppression. Developing behavioral interventions targeting HIV transmission behaviors toward patients with unsuppressed HIV VLs in the hospital setting has the potential to prevent HIV transmission.

Spatial Distribution of Partner-Seeking Men Who Have Sex With Men Using Geosocial Networking Apps: Epidemiologic Study

Background

Geosocial networking apps have made sexual partner-seeking easier for men who have sex with men, raising both challenges and opportunities for human immunodeficiency virus and sexually transmitted infection prevention and research. Most studies on men who have sex with men geosocial networking app use have been conducted in large urban areas, despite research indicating similar patterns of online- and app-based sex-seeking among men who have sex with men in rural and midsize cities.

Objective

The goal of our research was to examine the spatial distribution of geosocial networking app usage and characterize areas with increasing numbers of partner-seeking men who have sex with men in a midsize city in the South.

Methods

Data collection points (n=62) were spaced in 2-mile increments along 9 routes (112 miles) covering the county encompassing the city. At each point, staff logged into 3 different geosocial networking apps to record the number of geosocial networking app users within a 1-mile radius. Data were collected separately during weekday daytime (9:00 AM to 4:00 PM) and weekend nighttime (8:00 PM to 12:00 AM) hours. Empirical Bayesian kriging was used to create a raster estimating the number of app users throughout the county. Raster values were summarized for each of the county's 208 Census block groups and used as the outcome measure (ie, geosocial networking app usage). Negative binomial regression and Wilcoxon signed rank sum tests were used to examine Census block group variables (eg, median income, median age) associated with geosocial networking app usage and temporal differences in app usage, respectively.

Results

The number of geosocial networking app users within a 1-mile radius of the data collection points ranged from 0 to 36 during weekday daytime hours and 0 to 39 during weekend nighttime hours. In adjusted analyses, Census block group median income and percent Hispanic ethnicity were negatively associated with geosocial networking app usage for all 3 geosocial networking apps during weekday daytime and weekend nighttime hours. Population density and the presence of businesses were positively associated with geosocial networking app usage for all 3 geosocial networking apps during both times.

Conclusions

In this midsize city, geosocial networking app usage was highest in areas that were more population-dense, were lower income, and had more businesses. This research is an example of how geosocial networking apps’ geospatial capabilities can be used to better understand patterns of virtual partner-seeking among men who have sex with men.

Preliminary Findings of a Technology-Delivered Sexual Health Promotion Program for Black Men Who Have Sex With Men: Quasi-Experimental Outcome Study

BACKGROUND

Human immunodeficiency virus (HIV) disproportionately affects black men who have sex with men (MSM), yet there are few evidence-based interventions specifically designed for black MSM communities. In response, the authors created Real Talk, a technology-delivered, sexual health program for black MSM.

OBJECTIVE

The objective of our study was to determine whether Real Talk positively affected risk reduction intentions, disclosure practices, condom use, and overall risk reduction sexual practices.

METHODS

The study used a quasi-experimental, 2-arm methodology. During the first session, participants completed a baseline assessment, used Real Talk (intervention condition) or reviewed 4 sexual health brochures (the standard of care control condition), and completed a 10-minute user-satisfaction survey. Six months later, participants from both conditions returned to complete the follow-up assessment.

RESULTS

A total of 226 participants were enrolled in the study, and 144 completed the 6-month follow-up. Real Talk participants were more likely to disagree that they had intended in the last 6 months to bottom without a condom with a partner of unknown status (mean difference=-0.608, P=.02), have anal sex without a condom with a positive man who was on HIV medications (mean difference=-0.471, P=.055), have their partner pull out when bottoming with a partner of unknown HIV status (mean difference=-0.651, P=.03), and pull out when topping a partner of unknown status (mean difference=-0.644, P=.03). Real Talk participants were also significantly more likely to disagree with the statement "I will sometimes lie about my HIV status with people I am going to have sex with" (mean difference=-0.411, P=.04). In terms of attitudes toward HIV prevention, men in the control group were significantly more likely to agree that they had less concern about becoming HIV positive because of the availability of antiretroviral medications (mean difference=0.778, P=.03) and pre-exposure prophylaxis (PReP) (mean difference=0.658, P=.05). There were, however, no significant differences between Real Talk and control participants regarding actual condom use or other risk reduction strategies.

CONCLUSIONS

Our findings suggest that Real Talk supports engagement on HIV prevention issues. The lack of behavior findings may relate to insufficient study power or the fact that a 2-hour, standalone intervention may be insufficient to motivate behavioral change. In conclusion, we argue that Real Talk's modular format facilitates its utilization within a broader array of prevention activities and may contribute to higher PReP utilization in black MSM communities.